Dialysis in crisis: Delivering renal replacement therapy in disasters, conflicts, and resource-constrained settings

Authors

  • Sourabh Sharma Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India;
  • Rasha Darwish Kasr Alainy Faculty of Medicine, Cairo University. Egypt;
  • Sanjay Kalra Department of Endocrinology, Bharti Hospital, Karnal, India; University Centre for Research & Development, Chandigarh University, Mohali, India;
  • Sabine Karam Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA.

DOI:

https://doi.org/10.47391/JPMA.25-79

Abstract

Access to dialysis during crises such as natural disasters,armed conflicts, pandemics, or in low-resource settingsremains a significant global challenge. Vulnerablepopulations requiring chronic or acute dialysis aredisproportionately affected by disruptions ininfrastructure, supply chains, human resources, and wateror power availability. This article explores the operational,clinical, ethical, and logistical challenges faced whiledelivering dialysis in crisis scenarios. Drawing from globalcase studies including earthquakes in Japan, war zones inGaza, water-stressed regions, and lessons from theCOVID-19 pandemic, this paper highlights feasiblemodels of care, outlines adaptive strategies, and proposesa framework to improve dialysis delivery duringemergencies.

Keywords: Crisis, Conflict, Dialysis, Disaster management,Emergency medicine, Humanitarian Health, PeritonealDialysis, Renal replacement therapy

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Published

2025-09-25

How to Cite

Sourabh Sharma, Rasha Darwish, Sanjay Kalra, & Sabine Karam. (2025). Dialysis in crisis: Delivering renal replacement therapy in disasters, conflicts, and resource-constrained settings. Journal of the Pakistan Medical Association, 75(10), 1646–1648. https://doi.org/10.47391/JPMA.25-79

Issue

Vol. 75 No. 10 (2025): OCTOBER

Section

ADVANCES IN NEPHROLOGY

License

Copyright (c) 2025 Journal of the Pakistan Medical Association

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.